A new, large-scale program aimed at treating hypertension improved blood pressure control by 80 percent, according to a new study.

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TUESDAY, August 20, 2013 —
Fewer than 50 percent of Americans with high blood pressure have
their condition under control, despite available effective treatments, but
according to a new study published in the Journal of the American Medical
Association, large-scale programs aimed at helping
patients with hypertension can improve control by more than
80 percent. Experts say that the findings show that if the program was widely
implemented, it could vastly improve this often poorly controlled disease.

"Hypertension
affects 65 million adults in the United States (29 percent) and is a
major contributor to cardiovascular disease,” the researchers, led by
Marc Jaffe, MD, an internist at the Kaiser Permanente South San Francisco
Medical Center, wrote in the study. “Although effective therapies
have been available for more than 50 years, fewer than half of Americans with
hypertension had controlled blood pressure in 2001 to 2002. Many quality
improvement strategies for control of hypertension exist, [but until now], no
successful, large-scale program sustained over a long period has been
described.”

The researchers looked at more than 350,000 people
with hypertension and followed them between 2001 and 2009. The patients were
given a multifaceted approach to their high blood pressure, which included the
sharing of performance metrics, medical assistant visits for regular blood
pressure readings and combination drug therapy.

Throughout the study, blood pressure control
improved from 43.6 percent in 2001 to 80.4 percent in 2009, compared to the
national control rate, which improved from 55.4 percent to 64.1 percent over
that same period.

"This is the first successful, large-scale
program sustained over a long period of time," Dr. Jaffe said in a
statement. "Following the study period, our hypertension control rates
have continued to improve from nearly 84 percent in 2010 to 87 percent in 2011.
This has huge implications for the health of our members because this success
translates into reduced risk of stroke and heart disease."

Jeffrey Borer, MD, chief of cardiovascular medicine
at SUNY Downstate Medical Center in New York City, said this type of
large-scale program could help increase control rates across the
country.

“I have no doubt that the program is an
effective way to at lower blood pressure,” Dr. Borer said.
“If it could be applied to a lot of people, then the
outcomes would be even better. “

Helping Treat a Difficult
Disease

Hypertension is an extremely difficult disease to
treat, Borer said, and the major reason is that not everyone responds to treatment.

“There’s a certain segment of
the population, which may be as much as 15 percent, with drug-resistant
hypertension,” he said. “They have a very hard time
controlling the disease, if they even can.”

And even in people who do respond, to treatment,
getting them to take their medicine regularly has proven to be a big problem
for doctors, Borer added.

“Treatment
adherence is often poor for hypertension, mainly because of side
effects [which include frequent urination, erectile dysfunction and
weakness],” he said. “An additional problem is that doctors
are giving drugs to people who usually feel well. Hypertension is an
asymptomatic disease, so they question why they need to take the
drug.”

One of the best ways to not only prevent
hypertension, but to help control it as well, is to have your blood pressure
taken often, Borer said.

"People often don’t
go to their doctor and have their blood pressure checked annually," he
said. "Many times they may not even know they have a problem."

“Consuming
more fresh foods — vegetables, fruits, legumes, lean meats and fish,
and low fat dairy products — and fewer foods that are processed will
help decrease sodium intake,” McMurry said. “Eat more
home-prepared foods where you have more control over sodium [and] use herbs and
spices to add flavor to foods instead of salt and ingredients high in
sodium.”

Ultimately, Borer said that while the program is
effective at helping to treat a difficult disease, there is nothing magical
about it – it all comes down to monitoring high blood pressure
effectively.

“There’s no question that if
people are paying attention to their blood pressure, taking medication and
getting screened regularly, control is going to improve,” he
said.

Key Takeaways:

65 million adults in the U.S. have hypertension,
but less than half have it under control

The program improved blood pressure control by
80 percent

Having at least one blood pressure reading annually and regularly taking medication made the biggest impact

A single combination pill of a diuretic and the blood pressure drug lisinopril was cheaper and more effective than taking two separate medications

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